New AI Case in Guangdong Grudgingly Admitted:

UNCLAS SECTION 01 OF 03 GUANGZHOU 006174 SIPDIS SENSITIVE SIPDIS STATE FOR EAP/CM STATE PLEASE PASS NIH USDOC FOR 4420/ITA/MAC/MCQUEEN, CELICO, DAS LEVINE STATE PASS USTR USPACOM FOR FPA E.O. 12958: N/A TAGS: KFLU TBIO EAGR PGOV CH SUBJECT: New AI Case in Guangdong Grudgingly Admitted: More Cases to Come? (U) THIS DOCUMENT IS SENSITIVE BUT UNCLASSIFIED. PLEASE PROTECT ACCORDINGLY. NOT FOR RELEASE OUTSIDE U.S. GOVERNMENT CHANNELS. NOT FOR INTERNET PUBLICATION. ¶1. (SBU) SUMMARY: At 1130 on Saturday March 4, the Guangdong Foreign Affairs Office (FAO) faxed a diplomatic note (completely in Chinese with no English translation -- Consulate Guangzhou's translation in full text below) confirming the death of a Guangzhou man after contracting the H5N1 strain of avian influenza (AI). Subsequent government investigations indicate that the man contracted the disease because of his frequenting of 12 various live poultry "wet markets" in the heart of Guangzhou. He fell ill on February 22, and died March 2. On the same day of the death, top Guangdong public health officials declared to a U.S. medical military delegation that no reported AI case (human or animal) had occurred in over a year in Guangdong province. This misinformation comes in addition to other reported media blackouts. It appears that it is only because of pressure of Western media leaks, which eventually forced mainland media to provide more detailed information today. END SUMMARY. Frequenting "Wet" Markets Probable Culprit -------------- ¶2. (SBU) According to the FAO diplomatic note, the victim was a 32-year old, jobless, Guangzhou resident, named Lao Moumou. He fell ill on February 22, had signs of fever and pneumonia, and the illness developed rapidly. He failed to respond to medical treatments and died on March 2. Xinhua reported on March 4 that preliminary investigations revealed Lao had spent extended periods near a live poultry slaughterhouse in order to conduct market surveys. Additionally, the Southern Metropolis Daily reported Lao had visited 12 different wet markets in central Guangzhou. Government Reaction -------------- ¶3. (SBU) The Guangzhou Consulate only received official confirmation of the case on March 4, when the Chinese government sent a diplomatic note. The note, although lacking an English translation (Guangzhou Consulate translation provided),was significant in terms of its detail. Text of diplomatic note: -------------- March 4, 2006 Diplomatic Note No. 2006-15 To All Foreign Consulates in Guangzhou: The Guangdong Provincial People's Government Foreign Affairs Office would like to notify all foreign consulates in Guangzhou that a case of human infection of avian influenza has been discovered in the Guangzhou metropolitan area. The following are the details: The victim, LAO Moumou, male, age 32, unemployed, is a registered resident of Guangzhou. On 22 February, the victim fell ill, became bed-ridden with fever, and showed signs of pneumonia. Because his illness became serious very rapidly and treatments were ineffective, he died at noon on 2 March. According to the findings of a preliminary influenza study, the victim had visited agricultural markets frequently to conduct market research before he became ill. He had spent a lot of time at a spice store that was in the vicinity of a stall where live chicken are slaughtered. The Guangdong Provincial Center for Disease Prevention and Control conducted an examination of the victim and assessed that the virus A/H5N1 was present. A specialist group from the Guangdong Provincial Health Department, following the Central Government's guidelines set on human infection of GUANGZHOU 00006174 002 OF 003 avian influenza, made the preliminary conclusion that the victim is a suspected human case of avian influenza. After receiving the report from the Guangdong Provincial Health Department, the leaders of the Guangdong Provincial Government has given the situation serious attention, requesting the all relevant departments must follow the set guidelines to report any other human cases of avian influenza, implement all the prevention and control measures, ensure that all those exposed are quarantined properly for examination, disinfect all the places where the disease has the potential to be transmitted, so that the disease cannot spread. The Health Department has taken the necessary prevention and control measures, and has put the people with close contact to the victim under examination by medical personnel. The Provincial Health Office has tasked the Health Department to provide a definitive conclusion on the above case. End Text of diplomatic note -------------- ¶4. (SBU) In response to discovering a human AI victim, the Guangdong government immediately launched emergency measures to prevent and control the spread of the disease, according to Xinhua. Since March 1, city and district Centers for Disease Control and the hospital that treated the patient have taken a series of measures, including epidemiology investigation, medically surveying the victim's close contacts and disinfecting his places of contact. Experts are scrambling to discover if the poultry at the Guangzhou market where Lao may have contracted AI had been vaccinated and where the birds came from, according to Hong Kong press reports. The information on the Guangzhou case has been reported to the Ministry of Health who has reported the case to the WHO, Hong Kong, Macao and Taiwan, and a few countries. At a press conference held March 5, Health Minister Gao Qiang said so far no second case had been detected. Additionally, a spokesman with the Health, Welfare and Food Bureau of Hong Kong said on March 5 that Hong Kong has decided to suspend live poultry imports from Guangdong for the next three weeks (see Hong Kong septel). ¶5. (SBU) In addition to the quarantine and human investigations, the Southern Metropolis Daily reports officials have been inspecting the scene of the incident. Yesterday the Guangdong Animal Epidemic Supervision Institute and the Guangzhou Animal Epidemic Supervision Institute inspected the wet markets in central Guangzhou where the victim is believed to have frequented. Inspectors collected samples of chicken and duck droppings from each store in the wet markets. The test result is expected to come out March 7. Official Denial to PACOM Delegation -------------- ¶6. (SBU) Prior to the March 4 dipnote, Chinese officials gave no other warning to the Consulate. Most notably, on March 2, the Guangdong Public Health Department told a visiting U.S. delegation of military health experts from the U.S. Pacific Command that there were no cases of AI at all whether involving poultry, wild birds, or people in the province (for additional detail, see Guangzhou septel). Western Press Reports Misinformation and Cover-up -------------- -------------- ¶7. (SBU) Initially there was no press information on the AI case from mainland sources. In fact Hong Kong's South China Morning Post (repeated in the Reuters item) reported that Chinese authorities had attempted to muzzle news coverage, pointing out that "[T]he Guangdong propaganda and health departments jointly issued a notice to local media not to report on the case, saying there should be no coverage until it was confirmed." Chinese practice has been GUANGZHOU 00006174 003 OF 003 for central health authorities to confirm cases before they are permitted to be reported by the media or the local health authorities. Experts familiar with the situation in China have always maintained that there have been outbreaks of H5N1 in birds in Guangdong province as early as the first half of 2005, but Beijing has always denied this, according to Reuters. Mainland Press Reaction -------------- ¶8. (SBU) The first major mainland source to report the AI case was Xinhua on March 4. In Guangdong, local papers initially would not confirm the case as AI until March 6, when the Guangzhou Daily published a detailed timeline of the events. Originally medical officials believed the case might be SARS, but refuted this on February 28. According to their timeline, the case was reported at 11:10 p.m. to the Guangzhou Party Committee, Guangzhou municipal government and the Guangdong Provincial Public Health Department, which immediately reported to the Health Ministry. Comment: Guangzhou -- A Hotbed for AI? -------------- ¶9. (SBU) It is not entirely surprising an AI case has shown up in Guangdong. In an August 2005 Reuters article, an expert noted that South China is the perfect breeding ground for new diseases, and a likely starting point for a long overdue flu pandemic because of the warm weather and the proximity in which animals and humans live. A recent New York Times article also pointed out that while nearly a dozen Chinese provinces have acknowledged bird flu cases this winter, Guangdong province -- China's wealthiest and most populous province -- has not. On March 3, Dr. Zhong Nanshan, a Chinese expert on SARS and AI, when answering questions on contagious disease in China predicted that Guangdong and Hong Kong would most likely have an AI outbreak between February and June. Given that Guangdong is the birthplace of SARS, there has been some concern that AI would come to Guangdong sooner or later. As officials scramble to quarantine those in contact with Lao, to inspect local wet markets, and to stop the further spread of AI, it appears that sooner or later has unfortunately become sooner. DONG